New York Licensed SIU Investigator

Job Summary

A company is looking for an SIU Investigator to investigate allegations of potential healthcare fraud and abuse activity.

Key Responsibilities

• Conduct investigations of potential waste, abuse, and fraud
• Document activity on each case and refer issues to the appropriate party
• Perform data mining and analysis to detect aberrancies and outliers in claims

Required Qualifications

• Bachelor's Degree in Business, Criminal Justice, Healthcare, or related field, or equivalent experience required
• 5+ years in healthcare field working in fraud, waste, and abuse investigations and audits, or 5+ years of insurance claims investigation experience
• Professional investigation experience with law enforcement agencies is acceptable
• 7+ years of professional investigation experience involving economic or insurance-related matters may be considered